This invention relates to laparoscopic surgery and in particular to laparoscopic porting.
Laparoscopic surgical methods require that a portal of entry be created in an abdominal wall. This portal of entry is used to introduce an inert gas, such as carbon dioxide, into an abdominal cavity in a process called insufflation. By blowing-up the abdominal cavity like a balloon, a space is created inside the abdominal cavity that allows the surgeon to easily view and access the operative field. This portal of entry is also used for the sequential introduction and removal of surgical instruments such as video imaging devices, scissors, graspers, and devices for suctioning and irrigation of the abdominal cavity.
Methods of placing these portals are well known to surgeons. One method is to make an incision in the skin of the abdominal wall with a knife or other cutting instrument. This incision is carried down to a fascia or an inner fibrous layer of the abdomen. An opening is then created in the fascia large enough to accommodate a cannula or a port device. Surgical sutures are then placed in the edges of the opening of the fascia. The cannula or port device is then inserted through the incision in the skin, through the hole in the fascia, and into the abdominal cavity. The sutures are then wrapped or tied around the port device to retain it during the operation. The port device then acts as a conduit for surgical instruments as described above.
It is an important object of the invention to provide improved laparoscopic porting.
In one aspect, the invention is a retaining collar for laparoscopic surgery. The retaining collar includes a compressible and elastic body that has an inner periphery and an outer periphery where the inner periphery forms a conduit for receiving and securing a tubular device. The retaining collar also includes a rigid portion attached to the compressible and elastic body. The rigid portion has an inner periphery, an outer periphery and a cam lock. The inner periphery forms an aperture, that aligns with the conduit. The cam lock receives and retains a suture.
The invention may have one or more of the following features. The outer surface of the compressible and elastic body has a slit for receiving the suture. The outer periphery of the rigid portion having a slot for receiving the suture. The compressible and elastic body is constructed from polyurethane. The compressible and elastic body forms a sealing bias during carbon dioxide insufflation. The tubular device is a surgical device used in an abdominal area. The collar is conically shaped. The collar is bullet shaped.
In another aspect, the invention is a method of performing laparoscopic surgery. The method includes inserting a tubular device through a collar where the collar includes a compressible and elastic body having an inner periphery and an outer periphery. The inner periphery forms a conduit for receiving and securing the tubular device. The collar also includes a rigid portion attached to the compressible and elastic body where the rigid portion has an inner periphery, an outer periphery, and a cam lock. The inner periphery forms an aperture that is aligned with the conduit. The method also includes pulling a suture through the cam lock and retaining the suture using the cam lock.
One or more of the following features may be included in the invention. The method includes pulling the suture through the slit formed on the outer surface of the compressible and elastic body and pulling the suture through a slot of the outer periphery of the rigid portion. The method includes stitching through a tissue. The method includes forming a sealing bias during insufflation. The method includes passing surgical instruments through the tubular device.
The retaining collar provides a seal between the retaining collar and the opening in the abdominal wall to prevent the escape of carbon dioxide gas during insufflation due to the shape and compressible nature of the compressible and elastic body. In addition, the conduit through the compressible and elastic body of the retaining collar secures the tubular device while allowing variation in the diameter of the port device as well as adjustments in depth and position of the device while also maintaining a seal. Finally, the cam lock allows for easy accessibility in suturing an incision.
Other features, objects and advantages will become apparent from the following detailed description when read in connection with the accompanying drawing in which: